Urinary cAMP excretion during surgery. An index of successful parathyroidectomy in patients with primary hyperparathyroidism

Allen M. Spiegel, S. J. Marx, M. F. Brennan, E. M. Brown, J. O. Koehler, G. D. Aurbach

Research output: Contribution to journalArticle

25 Citations (Scopus)

Abstract

Urinary phosphate (U(p)) and urinary cAMP (U(cAMP)) excretion were determined in patients undergoing neck exploration for primary hyperparathyroidism in order to evaluate these parameters as indices of successful surgery. U(cAMP) fell below 1.5 μmol/g creatinine in all 12 patients in whom single gland removal corrected hypercalcemia and in 0 of 3 patients in whom no parathyroid tissue was found. The mean time to drop below 1.5 was 2.0 ± 0.8 hr (mean ± SD) from the time of parathyroidectomy. U(cAMP) fell below 1.5 in only 1 of 6 patients who had multiple enlarged parathyroid glands removed, irrespective of the outcome of surgery. Changes in U(p) excretion lagged behind U(cAMP) changes, so that within the time period studied U(p) fell to varying degrees in only 10 of 15 patients in whom hypercalcemia was corrected. A spurt in U(cAMP) excretion, possibly reflecting parathyroid hormone release due to manipulation of a parathyroid gland, occurred in 3 patients. The results suggest that an intraoperative fall in U(cAMP) below 1.5 predicts successful parathyroidectomy and that an intraoperative spurt in U(cAMP) may provide a clue to the location of abnormal parathyroid tissue.

Original languageEnglish (US)
Pages (from-to)537-542
Number of pages6
JournalJournal of Clinical Endocrinology and Metabolism
Volume47
Issue number3
StatePublished - 1978
Externally publishedYes

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Parathyroidectomy
Primary Hyperparathyroidism
Surgery
Tissue
Parathyroid Hormone
Creatinine
Parathyroid Glands
Phosphates
Hypercalcemia
Neck

ASJC Scopus subject areas

  • Biochemistry
  • Endocrinology, Diabetes and Metabolism

Cite this

Urinary cAMP excretion during surgery. An index of successful parathyroidectomy in patients with primary hyperparathyroidism. / Spiegel, Allen M.; Marx, S. J.; Brennan, M. F.; Brown, E. M.; Koehler, J. O.; Aurbach, G. D.

In: Journal of Clinical Endocrinology and Metabolism, Vol. 47, No. 3, 1978, p. 537-542.

Research output: Contribution to journalArticle

Spiegel, Allen M. ; Marx, S. J. ; Brennan, M. F. ; Brown, E. M. ; Koehler, J. O. ; Aurbach, G. D. / Urinary cAMP excretion during surgery. An index of successful parathyroidectomy in patients with primary hyperparathyroidism. In: Journal of Clinical Endocrinology and Metabolism. 1978 ; Vol. 47, No. 3. pp. 537-542.
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